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PLC:

a00411

Agency:

town of barton

For:

sewer/water payments remote

Phone:

607-565-2261 x5

Address:

304 route 17c
waverly, new york 14892

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*Last:

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*Account # 1 Amount:

Account # 2:

Account # 2 Amount:

Account # 3:

Account # 3 Amount:

Notes:

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Subtotal:

$0.00

Total:

$0.00

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*Last Name:

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*City:

*State/Province:

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*Credit/Debit Card:

(enter the full card number without any dashes or spaces)

*Expiration Date:

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